Private Duty

Consider using an assessment tool to identify clients who would be in greatest need of assistance during emergencies.

Doing this kind of preparatory work will help your agency better protect clients in the event disaster strikes in your area.

About 4 a.m. Oct. 9, with a massive wildfire raging, employees with At Your Service Home Care in Santa Rosa, Calif., were able to pull up clients’ contact numbers and call people living in affected areas.

The agency already had done legwork ahead of time. The agency uses an assessment to identify which members of its client population are “most vulnerable” in the event of an emergency. Clients who are bedbound, for instance, are deemed to be in greater need of assistance.

In At Your Service’s office, the agency pulled up clients’ records in its internet-based records system.

First agency employees called the homes of clients in the worst physical health — clients requiring around-the-clock care.

Then employees called clients who live alone.

Finally, employees called clients who had a family member living with them.

Various tools exist to help providers identify which clients would be most in need of assistance in a disaster. One was created by Diane Link, director of clinical services with Conshohocken, Pa.-based BlackTree Healthcare Consulting. (See related tool.)

Agency shares its fire experiences

In October 2017, wildfires across eight California counties required 100,000 people to evacuate, killed at least 42 people and destroyed roughly 8,400 structures, according to the San Francisco Chronicle.

While the blazes burned down homes for several At Your Service staff members and clients, no clients or employees were physically injured.

For Dr. Lucy Andrews, the agency’s owner/CEO, the incident began early Oct. 9 when she was forced to quickly evacuate her home — so quickly she had to leave behind her horse and five goats.

She and other At Your Service employees wound up evacuating to the office.

In fact, by the end of the day the agency’s office had mattresses on the floor and a motor home outside. Among the evacuees in the building: 20 people, seven dogs, six cats and a hamster.

Agency’s calls warned clients of blaze

About 4 a.m. Oct. 9, At Your Service employees woke up several clients and alerted them to the blaze.

If agency employees were at the clients’ homes, those caregivers were directed to drive the clients to a family member or, if necessary, the agency’s office.

If clients were on their own and could drive, they were directed to evacuate.

For clients who were on their own and who could not drive, the agency tried to help contact their family members or send caregivers to help.

The agency did its best to guide clients and staff to safety.

“We had them try and drive South, because we knew the fire was north of them,” Andrews says.

Caregivers in safer areas who weren’t on duty started calling in and asking if they could help.

“We only did that a couple times because they were going into the fire, basically,” Andrews says.

In those situations, the agency tried to keep the caregivers from driving far. It was gridlock on the roads and nearly impossible to get to certain areas.

“Mostly we did telephone triage for those clients who we could not get to,” Andrews says. “If we could, we let them know family was on the way.”

Prepare your agency for wildfires

Take worst-case scenarios into account when planning.

Regardless of whether you offer private duty services or Medicare skilled services, “you really need to have a good plan in place for, ‘What if?’” Andrews says.

This thought process during emergency planning, she says, should address the question: What if your agency is on its own with no possibility of help from law enforcement or the fire department, because those agencies are too busy dealing with the emergency itself?

“You can’t write your emergency plan around just calling 911, and they’ll transport whoever you need or tell you what to do,” Link agrees. “Even in normal emergencies, it doesn’t happen that way.”

Consider investing in technology that allows you to access clients’ records from anywhere.

Because At Your Service wasn’t relying on paper records, multiple employees could sign on remotely at the same time to access information about the agency’s client population.

The agency uses ClearCare for its medical records.

“We’re not burdened by paper,” Andrews says. “The old style was carrying around a binder. That person held the keys to the kingdom and knew what was going on, and God forbid anything happened to them.” — Josh Poltilove (jpoltilove@decisionhealth.com)

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